Abstract 14833: National Trends in Complications and 30-day Re-hospitalization After Lead Removal/extraction: Analysis From a Cohort Of 42,878 Patients

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Siva K Mulpuru ◽  
Peter A Noseworthy ◽  
Lindsey R Sangaralingham ◽  
Raphael Mawangi ◽  
Abhishek J Deshmukh ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Lead Removal ◽  
Complication Rates ◽  
Respiratory Complications ◽  
Cardiac Device ◽  
Cerebrovascular Complications ◽  
Heart Failure Exacerbation ◽  
Using Data ◽  
One Year ◽  
National Trends

Introduction: As the US population ages and indications for cardiac device implantation expand, there is a concomitant increase in patients undergoing lead removal/extraction (LR/E).. We sought to examine trends in outcomes and complications associated with LR/E. Methods: We conducted a retrospective analysis using data from a large U.S. commercial insurance database (privately insured and Medicare Advantage patients) identifying all patients undergoing LR/E between 2004 and 2013 with at least one year continuous medical plan enrollment prior to LR/E (to identify baseline comorbidities). Using ICD9 codes and CPT codes, major complications (hemorrhage requiring transfusion, vascular injury, pericardial complications, respiratory complications, cerebrovascular complications, and requirement for cardiac surgery) associated with LR/E and 30-day readmission rates were evaluated. Results: Among 42,878 patients who underwent LR/E (median age of 62 ( 54, 72) years, 70% male); approximately 1 in 40 experienced a major adverse event (2.4%) during the study period. Respiratory complications were the most common complication and 311 patients required cardiac surgery. 30-day readmission occurred in 11.1% of the total population. The most common reasons for readmission were heart failure exacerbation (18.7%) and device related complications (13.2%). Conclusion: The observed complication rates after LE/R in clinical practice are similar to those seen in recent clinical trials and have been relatively stable over the past 10 years.

The German CArdioSurgEry Atrial Fibrillation Registry: In-Hospital Outcomes

2021 ◽  
Author(s):  
Mahmoud Wehbe ◽  
Marc Albert ◽  
Thorsten Lewalter ◽  
Taoufik Ouarrak ◽  
Jochen Senges ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cardiac Surgery ◽  
Complication Rates ◽  
Hospital Data ◽  
Surgical Ablation ◽  
Operative Strategy ◽  
Cerebrovascular Complications ◽  
Ablative Procedures ◽  
Laa Closure

Abstract Background The aim of this study was to describe outcomes of patients undergoing surgical ablation for atrial fibrillation (AF) as either stand-alone or concomitant cardiosurgical procedures in Germany. Methods Patients with AF undergoing concomitant or stand-alone surgical ablation were included in the registry. Cardiac surgery centers across Germany were invited to participate and sought to enroll 1,000 consecutive patients. Data was obtained through electronic case report forms. The protocol mandated follow-up interviews at 1 year. Results Between January 2017 and April 2020, 17 centers enrolled 1,000 consecutive patients. Among concomitant surgical patients (n = 899), paroxysmal AF was reported in 55.4% patients. Epicardial radio frequency (RF) bilateral pulmonary vein isolation (PVI) with excision of the left atrial appendage (LAA) was the most common operative strategy. In the stand-alone cohort (n = 101), persistent AF forms were reported in 84.1% of patients. Moderate-to-severe symptoms were reported in 85.1%. Sixty-seven patients had previously underwent at least two failed catheter ablative procedures. Thoracoscopic epicardial RF bilateral PVI and completion of a “box-lesion” with LAA closure were frequently preformed. Major cardiac and cerebrovascular complications occurred in 38 patients (4.3%) in the concomitant group. No deaths were reported in the stand-alone group. At discharge, sinus rhythm was achieved in 88.1% of stand-alone and 63.4% concomitant patients. Conclusion The CArdioSurgEry Atrial Fibrillation registry provides insights into surgical strategies for AF ablation in a considerable cohort across Germany. This in-hospital data demonstrates that concomitant and stand-alone ablation during cardiac surgery is safe and effective with low complication rates.

scholarly journals Pros and cons of navigated versus conventional total knee arthroplasty—a retrospective analysis of over 2400 patients

2021 ◽  
Author(s):  
Matthias Meyer ◽  
Tobias Renkawitz ◽  
Florian Völlner ◽  
Achim Benditz ◽  
Joachim Grifka ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Retrospective Analysis ◽  
Outcome Measures ◽  
Knee Arthroplasty ◽  
Mechanical Axis ◽  
Complication Rates ◽  
Total Knee ◽  
One Year ◽  
Navigated Tka ◽  
Surgery Duration

Abstract Introduction Because of the ongoing discussion of imageless navigation in total knee arthroplasty (TKA), its advantages and disadvantages were evaluated in a large patient cohort. Methods This retrospective analysis included 2464 patients who had undergone TKA at a high-volume university arthroplasty center between 2012 and 2017. Navigated and conventional TKA were compared regarding postoperative mechanical axis, surgery duration, complication rates, one-year postoperative patient-reported outcome measures (PROMs) (WOMAC and EQ-5D indices), and responder rates as defined by the criteria of the Outcome Measures in Rheumatology and Osteoarthritis Research Society International consensus (OMERACT-OARSI). Results Both navigated (1.8 ± 1.6°) and conventional TKA (2.1 ± 1.6°, p = 0.002) enabled the exact reconstruction of mechanical axis. Surgery duration was six minutes longer for navigated TKA than for conventional TKA (p < 0.001). Complication rates were low in both groups with comparable frequencies: neurological deficits (p = 0.39), joint infection (p = 0.42 and thromboembolic events (p = 0.03). Periprosthetic fractures occurred more frequently during conventional TKA (p = 0.001). One-year PROMs showed excellent improvement in both groups. The WOMAC index was statistically higher for navigated TKA than for conventional TKA (74.7 ± 19.0 vs. 71.7 ± 20.7, p = 0.014), but the increase was not clinically relevant. Both groups had a similarly high EQ-5D index (0.23 ± 0.24 vs. 0.26 ± 0.25, p = 0.11) and responder rate (86.5% [256/296] vs. 85.9% [981/1142], p = 0.92). Conclusion Both methods enable accurate postoperative leg alignment with low complication rates and equally successful PROMs and responder rates one year postoperatively. Level of evidence III. Retrospective cohort study.

scholarly journals Center-Based Child Care and Differential Improvements in the Child Development Outcomes of Disadvantaged Children

2021 ◽  
Author(s):  
Sarah Anne Reynolds
Keyword(s):  
Child Care ◽  
Child Development ◽  
Economic Status ◽  
Value Added ◽  
Additional Time ◽  
Nationally Representative ◽  
Using Data ◽  
Development Outcomes ◽  
One Year ◽  
The Impact

Abstract Background Research finds center-based child care typically benefits children of low socio-economic status (SES) but few studies have examined if it also reduces inequalities in developmental disadvantage. Objective I test if the length of time in center-based care between ages one and three years associates with child development scores at age three years, focusing on the impact for groups of children in the lower tercile of child development scores and in the lower SES tercile. Method Using data from 1,606 children collected in a nationally representative Chilean survey, I apply a value-added approach to measure gains in child development scores between age one and three years that are associated with length of time in center-based child care. Results Disadvantages at age one year were associated with lower child development scores at age three years. No benefits of additional time in center-based care were found for the non-disadvantaged group, but positive associations were found between more time in center-based care and child development outcomes for children with the SES disadvantage only. Center-based care was not associated with child development trajectories of children with lower child development scores at age one year, no matter their SES status. Conclusions There is evidence that Chilean center-based child care reduces SES inequality in child development scores between ages one and three years, but only if children already were not low-scorers at age one year.

One-year outcome after cardiac surgery of patients with cancer: an observational monocentric retrospective study.

2021 ◽  
Author(s):  
Hadrien Portefaix ◽  
Grégory Papin ◽  
Elie Kantor ◽  
Bernard Iung ◽  
Philippe Montravers ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Retrospective Study ◽  
Patients With Cancer ◽  
One Year

scholarly journals Coprescribing of Benzodiazepines and Opioids in Older Adults: Rates, Correlates, and National Trends

2018 ◽  
Vol 74 (12) ◽  
pp. 1910-1915 ◽  
Author(s):  
Taeho Greg Rhee
Keyword(s):  
Older Adults ◽  
Future Research ◽  
Physician Visits ◽  
Prescribing Trends ◽  
Clinical Diagnoses ◽  
Nationally Representative ◽  
Using Data ◽  
National Trends ◽  
Ambulatory Medical Care ◽  
Over Time

Abstract Background To estimate prescribing trends of and correlates independently associated with coprescribing of benzodiazepines and opioids among adults aged 65 years or older in office-based outpatient visits. Methods I examined a nationally representative sample of office-based physician visits by older adults between 2006 and 2015 (n = 109,149 unweighted) using data from the National Ambulatory Medical Care Surveys (NAMCS). National rates and prescribing trends were estimated. Then, I used multivariable logistic regression analyses to identify demographic and clinical factors associated with coprescriptions of benzodiazepines and opioids. Results From 2006 to 2015, 15,954 (14.6%) out of 109,149 visits, representative of 39.3 million visits nationally, listed benzodiazepine, opioid, or both medications prescribed. The rate of prescription benzodiazepines only increased monotonically from 4.8% in 2006–2007 to 6.2% in 2014–2015 (p < .001), and the rate of prescription opioids only increased monotonically from 5.9% in 2006–2007 to 10.0% in 2014–2015 (p < .001). The coprescribing rate of benzodiazepines and opioids increased over time from 1.1% in 2006–2007 to 2.7% in 2014–2015 (p < .001). Correlates independently associated with a higher likelihood of both benzodiazepine and opioid prescriptions included: female sex, a visit for chronic care, receipt of six or more concomitantly prescribed medications, and clinical diagnoses of anxiety and pain (p < .01 for all). Conclusion The coprescribing rate of benzodiazepines and opioids increased monotonically over time in outpatient care settings. Because couse of benzodiazepines and opioids is associated with medication burdens and potential harms, future research is needed to address medication safety in these vulnerable populations.

scholarly journals Parameterization of ion-induced nucleation rates based on ambient observations

2010 ◽  
Vol 10 (9) ◽  
pp. 21697-21720 ◽  
Author(s):  
T. Nieminen ◽  
P. Paasonen ◽  
H. E. Manninen ◽  
V.-M. Kerminen ◽  
M. Kulmala
Keyword(s):  
Large Scale ◽  
Formation Rate ◽  
Global Radiation ◽  
Atmospheric Models ◽  
Organic Vapor ◽  
Depth Analysis ◽  
Using Data ◽  
One Year ◽  
Project Data ◽  
Semi Empirical

Abstract. Atmospheric ions participate in the formation of new atmospheric aerosol particles, yet their exact role in this process has remained unclear. Here we derive a new simple parameterization for ion-induced nucleation or, more precisely, for the formation rate of charged 2-nm particles. The parameterization is semi-empirical in the sense that it is based on comprehensive results of one-year-long atmospheric cluster and particle measurements in the size range ∼1–42 nm within the EUCAARI (European Integrated project on Aerosol Cloud Climate and Air Quality interactions) project. Data from 12 field sites across Europe measured with different types of air ion and cluster mobility spectrometers were used in our analysis, with more in-depth analysis made using data from four stations with concomitant sulphuric acid measurements. The parameterization was given in two slightly different forms: a more accurate one that requires information on sulfuric acid and nucleating organic vapor concentrations, and a simpler one in which this information is replaced with the global radiation intensity. In principle, these new parameterizations are applicable to all large-scale atmospheric models containing size-resolved aerosol microphysics.

scholarly journals FEMALE GENDER, LASER SHEATH USE AND OPERATOR SKILL DRIVE THE SUCCESS AND COMPLICATION RATES OF CARDIAC DEVICE LEAD EXTRACTION: AN ACAP REGISTRY ANALYSIS

2014 ◽  
Vol 63 (12) ◽  
pp. A381 ◽  
Author(s):  
Matthew Pierce ◽  
Balaji Pratap ◽  
Chaithanya Pamidimukala ◽  
Joseph Bastawrose ◽  
Archana Lingannan ◽  
...  
Keyword(s):  
Female Gender ◽  
Lead Extraction ◽  
Complication Rates ◽  
Cardiac Device ◽  
Registry Analysis

Does Nubility Indicate More Than High Reproductive Value? Nubile Primiparas’ Pregnancy Outcomes in Evolutionary Perspective

2021 ◽  
Vol 19 (3) ◽  
pp. 147470492110395
Author(s):  
William D. Lassek ◽  
Steven J. C. Gaulin
Keyword(s):  
Lower Risk ◽  
Reproductive Value ◽  
Age Group ◽  
Evolutionary Perspective ◽  
Normal Birth Weight ◽  
Normal Birth ◽  
Life Threatening ◽  
Widespread Availability ◽  
Using Data ◽  
One Year

The idea that human males are most strongly attracted to traits that peak in women in the nubile age group raises the question of how well women in that age group contend with the potential hazards of a first pregnancy. Using data for 1.7 million first births from 1990 U.S. natality and mortality records, we compared outcomes for women with first births (primiparas) aged 16–20 years (when first births typically occur in forager and subsistence groups) with those aged 21–25 years. The younger primiparas had a much lower risk of potentially life-threatening complications of labor and delivery and, when evolutionarily novel risk factors were controlled, fetuses which were significantly more likely to survive despite lower birth weights. Thus, nubile primiparas were more likely to have a successful reproductive outcome defined in an evolutionarily relevant way (an infant of normal birth weight and gestation, surviving to one year, and delivered without a medically necessary cesarean delivery). This suggests that prior to the widespread availability of surgical deliveries, men who mated with women in the nubile age group would have reaped the benefit of having a reproductive partner more likely to have a successful first pregnancy.

The Role of Internet Utilization Among SMEs on Household Welfare in Indonesia

2020 ◽  
Vol 9 (1) ◽  
pp. 25-37
Author(s):  
Ariska N. Rini ◽  
Lienggar Rahadiantino
Keyword(s):  
Internet Use ◽  
The Internet ◽  
Household Welfare ◽  
Capita Expenditure ◽  
Household Heads ◽  
Using Data ◽  
One Year ◽  
Small Medium Enterprises ◽  
Medium Enterprises ◽  
The Impact

The Internet has a significant influence on poverty alleviation and economic growth. Internet involvement in small-medium enterprises (SMEs) has the opportunity to create a better level of welfare. Using data from the fifth wave of the Indonesian Family Life Survey (IFLS), this study aims to analyze the impact of internet utilization on household welfare among two groups, household enterprises with internet use for business and without internet use for business. The results of the Propensity Score Matching (PSM) method mention that household enterprises with internet for business purposes have higher household per capita expenditure, food consumption, and non-food expenditure than household enterprises without internet use. Another interesting result finds that household enterprises are likely to use the internet only if household heads at a young age and business establish less than one year.

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